Grounds reports the psychiatric assessments of eighteen male exonerees, sixteen in the United Kingdom and two from other jurisdictions. The small sample is not necessarily representative and caution is recommended in making generalizations. Fifteen were wrongly convicted of murder (five in conjunction with terrorist bombings) and sentenced to life imprisonment; ten had served 11 years or more. Six made false confessions under interrogation pressure. Their average age on entry to prison was 28, and their average age on release was 38.

Before the assessments Grounds did not expect to find psychiatric morbidity. None of the men had significant past histories of psychiatric illness, and research on the effects of long-term imprisonment found little empirical evidence that incarceration generally leads to personality deterioration or psychiatric disorder.

The major finding was that most of the exonerees acquired serious psychological deficits including “enduring personality change after catastrophic experience” and PTSD. These are distinct diagnoses, although both are conditions that can follow exceptionally traumatic experience. There was evidence of additional disorders in 16 of the 18 cases, including depressive disorders, panic disorder, and paranoid symptoms. Three were socially isolated and developed alcohol or drug dependence to blot out their depression and PTSD symptoms. One-third of the men interviewed were living alone.

Their personality changes caused distress to them and their families. Sudden release without preparation or support led to difficulties in coping with ordinary practical tasks. Some found it difficult to adjust from the ordered prison environment to households where others kept moving possessions and household items. They learned to deal with emotional stresses in prison by blocking off painful feelings, avoiding communication, and isolating themselves. Upon release, they felt unsettled and could not find a sense of direction.

While they were in prison, their families had adapted to living without them; conflicts arose when they tried to return to family households. They related to their children in ways appropriate to the childrens’ ages at the time of arrest. They spoke of feeling, on release, psychologically the age they had been on entry to prison, a phenomenon common to long-term prisoners.

All had difficulties in family and other close relationships; for some the sense of closeness never returned. These feelings were difficult to admit and a source of immense guilt. Grounds was left with “a strong clinical impression of irreversible damage that could not be substantially remedied.”

These psychological and adjustment problems resulted from both the miscarriage of justice and long-term imprisonment. “The miscarriage of justice entailed acute psychological trauma at the time of initial arrest in custody, involving experiences of overwhelming threat. In addition, there was chronic psychological trauma: years of notoriety, fear, and isolation in their claims of innocence.”

Upon release, the prisoner and the family should be informed about likely problems. The exonerees may need long-term counseling, and work with families is needed to facilitate mutual understanding and coping strategies.